Camp Staff Registration Form Camp Staff - UW

Camp Staff
Camp Staff
Registration Form
UW-Oshkosh Cross Country Camp - July 17-21
Go to www.uwoshkoshsportscamps.com to register or fill out the form below.
Coach Eamon McKenna is serving his third
year as Head Men’s Cross Country and Track
& Field Coach at UW-Oshkosh. In his time at
UWO, he has coached an All-American athlete
in cross country and in the 800m, 1500m,
steeplechase, 5000m and 10000m on the
track, as well as athletes on DMR and 4x400m
relay All-American teams. McKenna has 11
years of experience coaching high school and
college cross country and track & field studentathletes. As a former Titan athlete, McKenna
was a four-time All-American and captain of
the 2002 NCAA Championship cross country
team. This will be his seventh year working the
Green Lake Camp and his fourth as director.
Coach Jason Fast will serve as Green Lake
Camp counselor for the fourth time this
summer. Coach Fast is currently the Head
Men’s and Women’s Cross Country and Track
& Field Coach at Lawrence University in
Appleton, Wisconsin. Coach Fast has
produced numerous All-Conference and
Conference Champion performers in his 5
years as Head Coach, and his Men’s team
won the Conference Championship in Cross
Country in 2011. As a Titan student-athlete,
Fast was a member of the NCAA Champion
2002 Cross Country Team, and was a
multiple-time All-Conference performer.
COMPLETE THE FORM BELOW TO REGISTER – PLEASE PRINT CLEARLY
Name______________________________________________
Last
First
MI
Address____________________________________________
City_______________________ State______ ZIP___________
Age_______Gender_____________ Grade in Fall 2016_______
School Attending in Fall 2016____________________________
Coach/Director of Team/Program_________________________
Roommate Preference_________________________________
Parent/Guardian______________________________________
Work Phone (____)__________ Cell Phone (____)___________
Email_______________________________________________
Emergency Contact___________________________________
Coach McKenzie Kelly will serve as Green
Lake Camp counselor for the first time this
summer. She has experience coaching at the
college and high school level as an assistant.
As a Titan student athlete, Kelly earned 3 AllAmerican awards, she was a member of the
NCAA Champion and National Record
breaking Distance Medley Relay Team, and
she is top 15 All-Time in the women’s 1500m
run. As a high school assistant, she helped
guide her boys team to the WIAA State Cross
Country Meet in 2014. McKenzie brings
another level of competitive experience to our
camp.
Coach Jordan Carpenter will serve as a Green
Lake Camp counselor for the third time this
summer. Jordan has competed and served as
a volunteer assistant at UW Oshkosh. Jordan
earned All-American honors with a 13th place
Nationals finish in 2015 and competed at the
NCAA Cross Country Championships all four
years of his career. He has been an AllConference performer 4 times on the track,
and he earned an All-American award in the
Steeplechase in 2014. Jordan carries a 4.0
GPA and is an NCAA Elite 89 Award and
NCAA Elite 90 Award winner for having the
highest GPA at the National Meet.
Work Phone (____)__________ Cell Phone (____)___________
T-Shirt Size (adult, circle one)
XL
L
M
S
Complete One:
Enclosed is $__________as full payment
Enclosed is $__________as deposit
Credit Card (circle one) Visa
(Balance is due by June 27, 2016)
MasterCard
American Express
Credit Card Number___________________________________
Exp. Date____________________ ID Code ________________
Cardholder Name (printed)______________________________
Cardholder Signature__________________________________
Insurance Company___________________________________
Insurance Company Address____________________________
Coach Brittany Haas returns to Green Lake
Camp as a counselor for the sixth year. She
currently serves as an Assistant Coach for
Boys’ and Girls’ Cross Country and Track &
Field at Oshkosh North High School. She has
helped coach multiple all-conference
performers and state qualifiers. As a runner at
UW Oshkosh, Haas competed at multiple
NCAA Championships. Brittany adds a level of
communication and care to our camp. Haas is
passionate about coaching, and she is a
dedicated leader.
Policy Holder________________________________________
Policy Number_______________________________________
I verify that my son/daughter has been checked by a licensed physician and is physically
able to participate in this Sports Camp/Clinic. I agree to allow my son/daughter to be
treated by a licensed physician while attending, if necessary, and to assume all costs
related to such treatment. I authorize my insurance company to pay benefits. Also, I
authorize the disclosure of medical information to my insurance company for the purpose
of a claim. I understand that if this application is accepted, there is no refund of the deposit
if we (parent or son/daughter) should cancel the application later.
The undersigned does hereby agree to hold harmless and indemnify the State of
Wisconsin, the Board of Regents of the University of Wisconsin System, and the University
of Wisconsin Oshkosh, their officers, agents and employees, from any and all liability, loss,
damages, costs, or expenses which are sustained, incurred, or required arising out of the
actions of my son/daughter in the course of the camp/clinic.
Parent/Guardian Signature ____________________________
About the Camp
It would be hard to find a more fitting setting for cross
country runners. Come train among 1000+ acres of
forest and meadows of the Green Lake Conference
Center located two miles west of Green Lake on Hwy
23 and on the north shore of Green Lake. This camp is
a co-ed distance training camp for high school cross
country runners.
A secret to success in competition is to be better
prepared than your opponent. This camp emphasizes
learning both theory and application of successful
cross country running. Workouts will be appropriate for
each athlete’s experience and condition. This is a
camp where each athlete can combine learning and
training while experiencing the joys of running.
The cross country camp offers a limited enrollment
with an athlete-to-counselor ratio of 9 to 1. This
unique grouping fosters a “team” atmosphere.
Through staff members sharing their extensive running
knowledge, you will gain experience in training
methods, exercise physiology, psychology of training
and racing, racing tactics, mechanics or running,
nutrition, cross training, injury prevention, and
rehabilitation. Recreational activities include swimming,
volleyball, tennis and softball. Canoes, bikes and
sailboats can also be rented. Campers are also
encouraged to bring their own bikes and games to
play.
Campers will arrive by 3:30 PM on Sunday, July 17.
Meals are served buffet style. Campers are welcome
to bring their own snacks. The camp concludes on
Thursday at noon.
Daily Camp Schedule
6:30 AM
6:45 AM
7:30-8:30 AM
9:15-10:45 AM
10:45-11:45 AM
12:00-1:00 PM
1:00-3:00 PM
3:15-4:45 PM
5:15-6:15 PM
6:30-8:00 PM
10:00 PM
10:30 PM
Wake Up
Morning Run
Breakfast
Instruction Session
Tournament Games (Volleyball,
Dodgeball, Ultimate Frisbee)
Lunch
Open Recreation and
Tournament Games (Volleyball,
Dodgeball, Ultimate Frisbee)
Workout
Dinner
Instruction Session
Quiet Hour
Lights Out
* Schedule could change depending on weather
Dates and Fees
Camp Dates: July 17-21, 2016
Fees: $390 on or before June 27, 2016
$425 after June 27, 2016
Fees include lodging, meals, tuition, camp t-shirt
and full use of Green Lake Conference Center’s
facilities. Fees also include the cost of prizes,
awards and miscellaneous social events. A
deposit of $50 should accompany the
registration form.
Go to www.uwoshkoshsportscamps.com to
register OR send the registration form, with a
minimum deposit of $50 to:
UW-Oshkosh Sports Camps
Kolf Sports Center
800 Algoma Boulevard
Oshkosh, WI 54901
Please make checks payable to UW-Oshkosh
Sports Camps and identify camper’s name on
check. Balance is due by June 27, 2016.
Cancellation Policy: Your fee, less a $50
nonrefundable deposit, will be refunded without
question if you cancel your enrollment two
weeks prior to the first day of camp. Any time
after this point, refunds will be made for medical
reasons only. Requests for refunds must be in
writing and accompanied by a signed excuse
from a physician. Campers who must leave
during the week due to illness or injury will
receive a prorated refund based on the number
of sessions attended. Requests for refunds must
be made within three months of the conclusion
of the camp.
CHARLEND HOWARD
ERICA MUNYAN
CROSS
JULY 17 - 21, 2016
COUNTRY
UWOSHKOSHSPORTSCAMPS.COM
KOLF ATHLETICS CENTER
CAMP